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Food Allergy or Foremilk/Hindmilk Imbalance?

I'm not really sure where to start with my question so forgive me if this is a little disorganized

My son is 10 weeks old and is having various issues - increased fussiness, extreme gassiness, explosive and frothy poop (usually very yellow, though, not often green or mucusy), waking up suddenly from naps in discomfort, intestinal discomfort in general, squirming during his sleep at night because of gas, congestion, gunky eyes, loud breathing, and now a diaper rash. He's generally a happy little guy except when he isn't feeling well in his stomach!

A lot of these issues he's had to varying degrees since he was born. He also used to have (and sometimes still has) an aversion to breastfeeding, which I found out was because I had overactive letdown and oversupply (he was about 3 or 4 weeks old at that time). I did some block feeding to reduce my supply a bit and since then I've been using only one breast per feeding to maintain the supply level, and I catch the extra intense flow of the first letdown in a burp cloth so he can then proceed to eat the rest happily. This strategy was maintaining the status quo for a while, but lately he's seemed to be in a lot more discomfort and sleeping poorly (he had been going for 4-5 hour stretches at night around 5 weeks, but now I'm lucky if he goes 3 hours without wanting to nurse - and most of the time at night he nurses just enough to gas and then is done).

Anyway, because of the explosive frothy poop and the diaper rash, both of which are newer developments, I'm starting to wonder if there is another problem going on besides the oald/os or if I'm just not managing those things well enough. Looking around the web it seems a lot of his symptoms could be food allergy symptoms, but I really just don't know how to tell, and I don't really know how to proceed if it is potentially a food allergy. And I just would like to see my baby happy and relaxed and able to sleep comfortably again

Oh and he is gaining weight well - started off life at 10lbs and was over 14lbs at his 2 month checkup So I'm not urgently worried about anything, there's just a lot of little things that seem to be making him uncomfortable and irritable.

Thanks so much for helping me figure out what might be going on and what I should try here

Mom to Rowan Michael, 07-11-2013, and still figuring how this whole motherhood thing! , soon to be , sometimes and (playing those things by ear, day to day).

Hoping that the depth of my love for my son will overcome the mistakes I'm bound to make as a mom!

Re: Food Allergy or Foremilk/Hindmilk Imbalance?

Welcome to the forum!

I think the first thing to focus on is that your LO is gaining weight just fine. When weight gain is normal, all the other concerns are pretty secondary. You have the basics down- you're just looking to tweak the fine points!

Everything you describe is in the normal realm for such a young baby. To me, it sounds like the problem is most likely a) oversupply/fast letdowns or b) normal baby behavior. Option c), allergy, is relatively rare by comparison to a) and b), and while you should not discount the possibility, you don't want to think of it as a likely scenario! Yes, the internet is a twitter with allergy talk- but remember that a huge amount of that is groupthink, people reinforcing each others' beliefs and concerns without any real data to back them up.

Since you still feed on just 1 breast at a time and still need to catch the first letdown in a burp cloth, I'm thinking you still have some oversupply/fast letdowns. That would explain most of what you're seeing nicely, including the following:
- The frothy, explosive poops
- The gassiness and fussiness
- The diaper rash- lots of poop output can result in a rash
- The excellent weight gain

A lot of what you're seeing is normal, including:
- Not sleeping more than 3 hours at a time- think of those 4-5 hour stretches as a gift your baby gave you, but one he's unlikely to let you keep!
- Being gassy and fussy, seeming to have trouble working out poops or farts- all par for the course with a young baby who is just figuring out how to use his digestive system.

The only things which I think might merit a little more attention are the gunky eyes- you might want to discuss the possibility of blocked tear ducts with your child's pediatrician- and the nighttime discomfort/squirming. While it's normal for a baby to have short sleep cycles, being uncomfortable during sleep might point to something like reflux.

Where is baby sleeping right now? I think the way to deal with this is to find a strategy that allows you to maximize your sleep and baby's comfort.

Re: Food Allergy or Foremilk/Hindmilk Imbalance?

Thanks! That is really reassuring (since I'm really hoping there isn't an allergy problem here!). Do you think it would be a good idea for me to go to two feedings per breast before switching? Is it possible to have oald but not os? I'm nervous about reducing my supply too much since I have to go to work in a couple weeks and will be pumping, which I've heard can reduce supply also.

I try to start the night with him in the bassinet, and then when he gets squirmy (which is sometimes immediately and sometimes not for a few hours) I take him in bed with me. Sometimes that will get him through the night comfortably, but some nights it doesn't seem to help and he's uncomfortable unless he's being held upright against my chest or over my shoulder. Last night was one of those nights... I was up with him from 1:30 on holding him upright for 15-30min until he relaxed, then sleeping in various places (bed, bassinet, crib, blanket on the floor) for 30-45min until he got squirmy again, then repeating the cycle, with nursing thrown in at various times, sometimes side-lying and sometimes holding him. Nothing really seems to work consistently except that upright position, which isn't really sustainable for the whole night because it requires me to stay awake so I don't drop him.

Mom to Rowan Michael, 07-11-2013, and still figuring how this whole motherhood thing! , soon to be , sometimes and (playing those things by ear, day to day).

Hoping that the depth of my love for my son will overcome the mistakes I'm bound to make as a mom!

Re: Food Allergy or Foremilk/Hindmilk Imbalance?

Block feeding- i.e. feeding on just one breast at a time for more than 1 feeding in a row- is designed to reduce supply and it is definitely possible to go too far. That, coupled with the fact that it is very possible to have fast letdowns and normal supply, means that block feeding is something you want to do only with caution. I don't know that I would take that path, were I in your shoes. Your baby's yellow poops point to a supply which is not too crazy far off from his needs. I mean, I think you probably do have an oversupply- but I don't know that block feeding is the step you want to take, particularly with a return to work looming.

If baby sleeps better upright, that could be a relfux indicator. Being upright means that gravity helps keep tummy contents- and tummy acids- down where they belong. I'd definitely discuss the possibility with the pediatrician. Do you have a swing? I'm thinking your baby might sleep well in one, especially if it keeps him just the slightest bit upright. Another thing that might help is if you elevate the head of his bed by sticking a pillow under the mattress.

Re: Food Allergy or Foremilk/Hindmilk Imbalance?

I have been going through pretty much all these issues with my almost 8 weeks old until the last week. One thing I found helpful to reduce that explosive frothy poop and general discomfort is cutting my dairy intake. I am restricting dairy right now to a cup of milk with cereal during breakfast and a tub of yoghurt during lunch. I have pretty much left out cheese. I have found that his crying has definitely gone down a notch and he seems more comfortable after meals. It has not completely disappeared though, and I am hoping it is only his young age and the immaturity of his digestive tract. Since he has been gaining weight fine, I am not too worried about these right now.I was in this terrible dilemma over foremilk/hindmilk imbalance, so I am letting him go as long as he likes on each breast rather than watching the clock and as long as his poop is not green I think he is okay.